Healthcare Provider Details

I. General information

NPI: 1972131217
Provider Name (Legal Business Name): VINSON DIEN VINH HUYNH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ENTRANCE WAY
SAINT PETERS MO
63376-1645
US

IV. Provider business mailing address

1501 N CAMPBELL AVE RM 4401
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 636-916-9000
  • Fax:
Mailing address:
  • Phone: 520-626-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberV1489
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2025042365
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: